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2021-016A
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2021-016A
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Last modified
2/1/2021 11:18:12 AM
Creation date
1/29/2021 10:49:27 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
01/19/2021
Control Number
2021-016A
Agenda Item Number
8.H.
Entity Name
Creative Solutions Companion Care Service, LLC
Subject
Agreement for Emergency Vaccine Administration Services
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This Agreement will be effective on January 6.20? ;013NT Y"CO " <br />OWNER: Pji�1JIDER: <br />INDIAN RIVER COUNTY = i �°r Cre�twe lutions Compa on are Service, LLC <br />' s . 651 <br />Jason E/Brov/n, County Administrator <br />APPROVEDASTO FORM AND LEG FICIENCY: <br />By: <br />Dyl n Reingold, County Attorney <br />Jeffrey R. mith, Clerk of Co comptroller <br />Attest: , <br />k& <br />Deputy Clerk <br />(SEAL) <br />Designated Representative: <br />Name: Tad Stone <br />Title: Emergency Services Director <br />Address: 4225 43`d Ave, Vero Beach, FL 32967 <br />Phone: 772-226-3947 <br />Email; tstone@ircgov.com <br />/ (Pr6vicyr) <br />(CORPORATE SEA <br />Attes <br />Designated Representative: nn 1 <br />Name: An-ah,4 L. �Jay Jzirci <br />Title: C& O <br />Address: 2$3j AAM—S <br />R 'v; ► c, 3 3 <br />Phone: 4-(4-0 <br />Email: ih��Crc+ASulul.�gs�CS•(yti, <br />(If PROVIDER is a corporation or a partnership, <br />attach evidence of authority to sign.) <br />
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